Blythe Anne Hamburg, P-LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

P-1098 Issued in MS

Practice address

401 Bailey Dr
Hollandale, MS 38748-3206

Phone

(662) 881-0281

NPI assigned

Sep 6, 2024

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1725580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725753600000",
    "number": "1093540148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 KEY RD",
            "city": "GREENVILLE",
            "state": "MS",
            "postal_code": "387019546",
            "telephone_number": "662-881-0281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 BAILEY DR",
            "city": "HOLLANDALE",
            "state": "MS",
            "postal_code": "387483206",
            "telephone_number": "662-881-0281"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "130 Key Rd",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "MS",
            "postal_code": "387019546",
            "country_code": "US",
            "telephone_number": "662-881-0281",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAMBURG",
        "first_name": "BLYTHE",
        "middle_name": "ANNE",
        "name_prefix": "Ms.",
        "credential": "P-LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-09-06",
        "last_updated": "2024-09-08",
        "certification_date": "2024-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MS",
            "license": "P-1098",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MS",
            "license": "P-1098",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MS",
            "license": "P-1098",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sara Leanne Davis, NP
• Delta Health Center, Inc.
• Jonmichael Diehl
• Sylvia Cope Duncan, LPC
• Ken J Gailes, PT
• Senthan Harris
• Thomas Hassett, PHARMACISTS
• Hollandale Family Care
• Hollandale Family Care, P.C.
• Hollandale Primary Care, Inc.

• Mental Health Counselor in Hollandale, MS
• Providers in Hollandale, MS by specialty
• Mental Health Counselor in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.